Monday, December 17, 2012

The Signs and Symptoms that a person is considering suicide.

By Alex Schadenberg

Executive Director - Euthanasia Prevention Coalition

I just received the email update from Your Life Counts a Canadian Charity that works to prevent suicide through education, intervention and listening to people in crisis. I have always been impressed with the fact that Your Life Counts focuses on individual people and families. They work with people in need.

Rory Butler

Your Life Counts is led by its founder, Rory Butler. Butler is a suicide survivor who has made it his life's work to stop Canada's silent epidemic.

The following article was featured in the recent Your Life Counts email update. It is the Signs and Symptoms that a person is considering suicide. When you know the signs and symptoms of suicide, you can better identify a potential risk or you can identify when intervention or support is required. Your Life Counts Facebook page.

Often contemplation of suicide is a result of someone being
overwhelmed by a variety of life circumstances. If you know what to look
for there are generally signs and symptoms pointing to the fact an
individual is contemplating suicide. What are the signs and symptoms?
And how should we react once we spot the signs or symptoms in our loved
ones or ourselves?

Symptoms that an individual is contemplating suicide often coincide
with those of depression. Symptoms often vary and depressive symptoms
are treatable. Usually the onset of symptoms is gradual and therefore
can go unnoticed. Even the person himself or herself may assume that he
or she is just transitioning into a “normal stage of life” where
relationships and experiences are no long as interesting or exciting as
they once were. This is not true.Depression and thoughts of suicide can be brought on by a variety of
causes, including setbacks or disappointments in life, loss, divorce or
breakup, financial stress, medical illness, family history and genetics,
trauma and stress (ranging from being unemployed to getting married),
pessimism, low self-esteem, physical conditions, medical conditions,
etc. Any one of these causes or a combination of several can contribute
to depression because they bring on physical weakness and stress.Depression or thoughts of suicide can affect anybody. The encouraging
news is that depression is very treatable and thoughts of suicide can
be turned into thoughts of hope. To find out your diagnosis and
potential treatment options, speak with your health care provider
immediately.There is help and hope available. Many people living with depression
or thoughts of suicide try to harm themselves because they believe that
they’re “stuck this way forever.” This isn’t true. Situations and
circumstances can change. Things will get better. Taking the first step
by deciding to seek treatment and support will make a big difference.SIGNS TO LOOK FOR:What are the warning signs?Saving the life of someone from suicide depends on our ability to
recognize those people who are in distress and may be at risk. The
American Association of Suicidology developed a simple tool that is
available for everyone to use to remember the warning signs of suicide.
This tool is called “IS PATH WARM” and outlines the key points to remember.I – Ideation (suicidal thoughts)S – Substance AbuseP – PurposelessnessA – AnxietyT – TrappedH – Hopelessness/HelplessnessW – WithdrawalA – AngerR – RecklessnessM – Mood changesOther signs and behaviours to be aware of and that might suggest
someone being at risk of suicide include – but are not limited to:

Direct and indirect verbal expressions: “I don’t want to live
anymore”, “there is nothing to live for anymore”, “people will be better
off without me”

Reconnecting with old friends and extended family as if to say goodbye

Previous unresolved or recent suicide attempt(s)

Unusual happiness and peace after an intense period of turmoil and displaying the above characteristics.

WHAT TO DO – SUICIDE FIRST AID

The following guidelines are based on the expert opinions of a panel
of mental health consumers, carers and clinicians from Australia, New
Zealand, the UK, the USA and Canada about how to help someone who may be
at risk of suicide.How to use these GuidelinesThese guidelines are a general set of recommendations about how you
can help someone who may be at risk of suicide. Each individual is
unique and it is important to tailor your support to that person’s
needs. These recommendations therefore may not be appropriate for every
person who may be at risk of suicide. Also, the guidelines are designed
to be suitable for providing first aid in developed English-speaking
countries. They may not be suitable for other cultural groups or for
countries with different health systems.

An important note:

Self-injury can indicate a number of different things. Someone who is
hurting themselves may be at risk of suicide. Others engage in a
pattern of self-injury over weeks, months or years and are not
necessarily suicidal. These guidelines can assist you only if the person
you are helping is suicidal. If the person you are assisting is
injuring themselves, but is not suicidal, please refer to an excellent
web resource hosted jointly by the University of Guelph and McGill
University at www.sioutreach.orgHow can I tell if someone is feeling suicidal?It is important that you know the warning signs of suicide.People may show one or many of these signs, and some may show signs not on this list.If you suspect someone may be at risk of suicide, it is important to
ask them directly about suicidal thoughts. Do not avoid using the word
‘suicide’. It is important to ask the question without dread, and
without expressing a negative judgment. The question must be direct and
to the point. For example, you could ask:

“Are you having thoughts of suicide?” or

“Are you thinking about killing yourself?”

If you appear confident in the face of the suicide crisis, this can be reassuring for the suicidal person.Although some people think that talking about suicide can put the
idea in the person’s mind, this is not true. Another myth is that
someone who talks about suicide isn’t really serious. Remember that
talking about suicide may be a way for the person to indicate just how
badly they are feeling.

How should I talk with someone who is suicidal?

It is important to:

Tell the suicidal person that you care and that you want to help them.

Express empathy for the person and what they are going through.

Clearly state that thoughts of suicide are often associated with a
treatable mental disorder, as this may instill a sense of hope for the
person.

Tell the person that thoughts of suicide are common and do not have to be acted on.

Suicidal thoughts are often a plea for help and a desperate attempt
to escape from problems and distressing feelings. You should encourage
the suicidal person to do most of the talking, if they are able to. They
need the opportunity to talk about their feelings and their reasons for
wanting to die and may feel great relief at being able to do this. It
may be helpful to talk about some of the specific problems theperson is experiencing. Discuss ways to deal with problems which seem
impossible to cope with, but do not attempt to ‘solve’ the problems
yourself.

How can I tell if the situation is serious?

First, you need to determine whether the person has definite
intentions to take their life, or whether they have been having more
vague suicidal thoughts such as ‘what’s the point of going on?’. To do
this, you need to ask the person if they have a plan for suicide. The
three questions you need to ask are:1. Have you decided how you would kill yourself?2. Have you decided when you would do it?3. Have you taken any steps to secure the things you would need to carry out your plan?A higher level of planning indicates a more serious risk. However,
you must remember that the absence of a plan is not enough to ensure the
person’s safety. All thoughts of suicide must be taken seriously.Next, you need to know about the following extra risk factors:

Has the person been using alcohol or other drugs? The use of alcohol
and other drugs can make a person more susceptible to acting on
impulse.

Has the person made a suicide attempt in the past? A previous
suicide attempt makes a person more likely to make a future suicide
attempt or to kill themselves.

From the Article “Suicidal Thoughts & Behaviours, First Aid Guidelines:” The Department of Psychiatry The University of Melbourne AUSTRALIAOnce you have established that the risk of suicide is present, you need to take action to keep the person safe.

How can I keep the person safe?

A person who is actively suicidal should not be left on their own. If
you can’t stay with them, you need to arrange for someone else to do
so. In addition give the person a safety contact which is available at
all times (such as a telephone help line, a friend or family member who
has agreed to help, or a professional help giver).It is important to help the suicidal person to think about people or
things that have supported them in the past and find out if these
supports are still available. These might include a doctor, psychologist
or other mental health worker, family member or friend, or a community
group such as a club or church.Do not use guilt and threats to prevent suicide. For example, do not
tell the person they will go to hell if they die by suicide, or that
they will ruin people’s lives by killing themselves.

What about professional help?

During the crisisMental health professionals advocate always asking for professional
help, especially if the person is psychotic. If the suicidal person has a
weapon or is behaving aggressively towards you, you must seek
assistance from the police in order to protect yourself.However, the person you are helping may be very reluctant to involve a
professional and, if the person is close to you, you may be concerned
about alienating them. In fact, some people who have experienced
suicidal thoughts or who have made plans for suicide feel that
professional help is not always necessary.After the crisis has passedAfter the suicide crisis has passed, ensure the person gets whatever
psychological and medical help they need. Other guides in this series
may be useful for you in achieving this.

What if the person makes me promise not to tell anyone else?

You should never agree to keep a plan for suicide a secret. However,
you should respect the person’s right to privacy see. There are
guidelines in this series entitled First aid guidelines for deliberate
self-injury which can help you to understand and assist if this is
occurring.

Do your best.

Do your best for the person you are trying to help. Remember, though,
that despite our best efforts, some people will still die by suicide.

2 comments:

needleartist
said...

I am living proof that suicide can be overcome. I lived with 'active suicide' for thirty-eight years and have been without these thoughts for over six years. My life is now enjoyable and multi-faceted. I am glad that assisted suicide was not available at that time because the best part of my life is what I am currently living.

I agree wholeheartedly with these guidelines! Indeed, it is very true that it is IMPOSSIBLE to "put the idea of suicide into someone's head" by talking about it. As a former hospice nurse, I am adamantly against euthanasia and assisted suicide. Palliative care has advanced to a point where most suffering can be alleviated and people are able to die with dignity WITHOUT resorting to unethical means.